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From the 10/15/2021 release of VAERS data:

This is VAERS ID 938576



Case Details

VAERS ID: 938576 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: New Jersey  
Vaccinated:2021-01-06
Onset:2021-01-09
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EK9231 / 2 LA / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EH9899 / 1 LA / SYR

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood test, Computerised tomogram, Deep vein thrombosis, Magnetic resonance imaging, Pulmonary embolism
SMQs:, Retroperitoneal fibrosis (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: All seafood
Diagnostic Lab Data: CT, MRI, blood teatst
CDC Split Type:

Write-up: Back pain, bilateral PE and DVT


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=938576

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